말소리장애아동의음운인식과어휘특성 서은영외 음운인식은단어의소리구조에대한인식을포함하는상위언어적기술로음운표상의질과관련이있다. 학령전기음운인식기술은학령기의읽기와철자를예측할수있고읽기해독, 이해, 유창성등과관련이있다 (Bradley & Bryant, 1983). 음운인식은음절과같

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1 ISSN (Online) Commun Sci Disord 2017;22(2): Original Article Phonological Awareness and Vocabulary Characteristics of Children with Speech Sound Disorders Eun-Young Seo a, Yoo-Kyeong Ko a, Gyung-Ah Oh a, Soo-Jin Kim b a Department of Communication Disorders, The Graduate School of Korea Nazarene University, Cheonan, Korea b Department of Communication Disorders, Korea Nazarene University, Cheonan, Korea Correspondence: Soo-Jin Kim, PhD Department of Communication Disorders, Korea Nazarene University, 48 Wolbong-ro, Seobuk-gu, Cheonan 31172, Korea Tel: Fax: sjkim@kornu.ac.kr Received: April 5, 2017 Revised: May 16, 2017 Accepted: May 26, 2017 Objectives: Phonological awareness (PA) skills and vocabulary knowledge are known to be significant predictors of later reading and literacy skills. There have been inconsistent reports about PA, characteristics of vocabulary, and their influences on literacy for children with speech sound disorders (SSD). The aim of this study is to investigate whether there are any differences in PA and vocabulary skills between SSD children and typically developing children (TD). Methods: The subjects were 24 TD children and 24 SSD children between 5 and 6 years old. These children were tested on articulation ability (percentage of correct consonants [PCC]), PA, and vocabulary skills. Results: The results are as follows. First, statistically significant differences were found in PA and vocabulary skills between age groups and SSD/TD groups. Second, PA skills had a stronger correlation with vocabulary knowledge than articulation ability (PCC). Thirty-three percent of SSD children showed delay in both PA and vocabulary. Sixteen percent of SSD children showed delay in phonological awareness only, and 16% of SSD showed delay in vocabulary skills only. Lastly, 33% of SSD children were considered to be pure SSD with no delay in any tested area. Conclusion: The researchers suggest that differential evaluation and intervention are crucial for SSD children with accompanying difficulties in PA and vocabulary skills. For SSD children with delay in PA and/or vocabulary skills, direct intervention and continued monitoring of early literacy skills should be required to prevent potential future literacy difficulties. Keywords: Speech sound disorder, Phonological awareness, Vocabulary, Literacy skill 말소리장애중원인을모르는말소리장애는원인이분명한경우를제외한것으로다양한원인에의해발생하고동반하고있는문제의유무나특성, 말소리의증상, 말처리과정등이다양한이질적인집단이다. 이러한이질적인집단을하위유형으로분류하고특성을밝혀내고자노력하는이유는치료예후를예측하고차별적인평가및중재접근을적용하는데중요하기때문이다. 특히이질적인말소리장애집단의동반문제를파악하는것은문제의특성을확인하고동반하고있는문제들사이의관계를이해함으로써궁극적으로중재에적용하기위해서고려되어야한다 (Bernthal, Bankson, & Flipson, 2013). 원인을모르는말소리장애의경우에도말소리산출상의문제만 을보이는경우는드물고인지, 심리, 사회, 의사소통등의문제를동반하고있는경우가많으며의사소통문제중언어, 음성, 유창성문제가동반문제로나타날수있다. 말소리장애아동이가장빈번하게동반하고있는문제로는언어문제가있으며어휘, 음운인식, 문해기술등에서도어려움을보일수있다 (Kim, Kim, Ha, & Ha, 2015). 특히언어와어휘, 음운인식문제가언급되는이유는말소리장애아동의이후문해기술을예측하고문해문제를예방하는데중요한요인이기때문이다. 학령전기의말소리장애아동은읽기와철자발달에중요한기술인음운인식에위험을보일가능성이크고이러한어려움이학령기이후에도지속될수있다 (Preston, Hull, & Edwards, 2013) Copyright 2017 Korean Academy of Speech-Language Pathology and Audiology This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

2 말소리장애아동의음운인식과어휘특성 서은영외 음운인식은단어의소리구조에대한인식을포함하는상위언어적기술로음운표상의질과관련이있다. 학령전기음운인식기술은학령기의읽기와철자를예측할수있고읽기해독, 이해, 유창성등과관련이있다 (Bradley & Bryant, 1983). 음운인식은음절과같은큰음운단위에서초성이나각운과같은중간단위를거쳐음절의초성, 종성을포함하는개별적인음소에대한인식으로발달한다 (Rvachew & Grawburg, 2006). 음운인식을평가하는방법은주로단어의음절이나음소수준에대한변별, 합성, 탈락과제를포함한다. 특히탈락과제는단어내에포함된음소에대하여보다직접적인조작과분리를요구하는과제이며일반아동과말, 언어장애혹은말과언어장애를동반하고있는 6세아동을변별해주는것으로나타났다 (Leitao, Hogben, & Fletcher, 1997). 또한음운인식과제중에서탈락과제가읽기성취를가장잘예측하며이후읽기와가장관련이높은것으로나타났다 (Catts, 1993; Torgesen, Wagner, & Rashotte, 1994; Yopp, 1988). 음운인식능력이부족한아동은초기문해기술의문제를보일수있는데 (Preston et al., 2013) 말소리장애아동의말소리산출의어려움과이후음운인식, 문해기술에서의결함사이에유의한상관관계가지속적으로보고되고있다 (Bird, Bishop, & Freeman, 1995; Dodd, 2005; Gillon, 2002; Rvachew, Ohberg, Grawburg, & Heyding, 2003; Snowling, Bishop, & Stothard, 2000). 또한음운표상의질은말소리산출에도영향을미치기때문에 (Preston & Edwards, 2010) 말소리장애아동은음운표상에대한질이나접근성이약하다는것을알수있다 (Anthony et al., 2011; Lewis, Freebairn, & Taylor, 2002). 그러나모든말소리장애아동이음운인식이나이후문해기술을습득하는데어려움을보이지않으므로 (Rvachew, 2007) 말소리장애아동이문해기술에어려움을보이는가를예측하는요인이나위험요인을파악하는것이중요하다. 말소리장애아동의음운인식및이후문해기술에영향을주는요인으로연령, 자음정확도, 어휘력, 말지각능력, 말소리오류의유형, 심각도등이선행연구에언급되고있다. 연령의측면에서일반적으로음운인식은아동의연령이증가하면서발달하고점차안정화되며 (McDowell, Lonigan, & Goldstein, 2007) 연령은음운인식과유의한상관관계가있다 (Foy & Mann, 2001). 말소리오류유형의측면에서특이한오류패턴을일관적으로사용하는아동은특히읽기상의어려움을보일수있다 (Dodd, 2005). 또한학령전기에비전형적오류를보이는말소리장애아동은음운인식능력이더약한것으로나타났으며, 이는비전형적인음운오류를산출하는것이약한음운표상을반영하는것이다 (Leitao, Hogben, & Fletcher, 2004; Preston & Edward, 2010). 비전형적음운오류를보이는말소 리장애아동의 93% 가음운인식에어려움을보인다는연구도있다 (Broomfield & Dodd, 2004). 어휘의측면에서학령전기어휘발달의크기와특성이음운인식발달에영향을주고 (Burgess & Lonigan, 1998; Hemphill & Tivnan, 2008) 이후문해기술을예측하는중요한요인이며 (Lonigan, Burgess, Anthony, & Barker, 1998; Metsala & Walley, 1998) 이것은말소리장애아동에게도해당한다 (Rvachew & Grawburg, 2006). 말지각의측면에서음운인식능력과관련하여말지각과음운표상의어려움이말소리장애의원인요인이라는것을제안하기도하였다 (Forrest, Chin, Pisoni, & Barlow, 1994; Munson, Edwards, & Beckman, 2005). 자음정확도의측면에서자음정확도와음운인식및읽기능력에대한많은연구들은자음정확도단독으로는음운인식과유의한상관관계가없고말소리오류의유형이나동반하고있는문제에따라다르다는것을보고하였다. 언어장애를동반하고있는말소리장애아동이언어장애를동반하지않은말소리장애아동보다더약한음운인식을보인다는것은많은연구를통해입증하였다 (Bird et al., 1995; Preston & Edwards, 2010). 그러나말소리장애아동의음운인식과이후문해기술에영향을미치는요인들에서어려움을보이지않은말소리문제만을보이는아동도음운인식이나읽기장애를보이기도하므로 (Anthony et al., 2011) 이러한요인들간의관계를파악하고하위유형으로분류함으로써각하위유형에적절한평가및중재접근이필요하다. 말소리장애아동이음운인식과어휘에지연을보이는비율을살펴본이전연구들은그비율에있어상당히큰차이를보이고있다. St. Louis, Ruscello 와 Lundeen (1992) 은말소리장애중 41% 가다른의사소통문제를동반하지않는다고보고하였다. 말소리장애아동이음운인식에지연을보이는비율에대해 28% 가지연을보인다고보고한연구도있고 (Preston & Edwards, 2010) 학령전기에말소리장애이력이있고초기학령기에부족한읽기를보이는아동의비율을 77% 혹은 60% 등으로다양하게보고하고있다 (Bird et al., 1995; Larrivee & Catts, 1999). 말소리장애아동이어휘에지연을보이는비율에대해 50% 가지연을보인다고보고한연구도있다 (Dodd, 2005). 국내에서는최근에말소리장애집단을하위유형으로분류하거나그특성을파악하고자하는노력을보이고있지만직접적인평가를통해실제로그관계를밝히거나하위유형으로분류한바는없다. 연구문제는다음과같다. 첫째, 연령과말소리장애유무에따른음운인식과어휘능력의차이를살펴보고둘째, 음운인식, 어휘, 자음정확도간상관관계를살펴보고셋째, 말소리장애아동이음운인식과어휘에서지연을보이는비율을제시하고자하였다

3 Eun-Young Seo, et al. Phonological Awareness and Vocabulary of Children with SSD 연구방법연구대상서울과경기, 충남, 제주지역에거주하는 5, 6세일반아동과말소리장애아동들로각연령집단별 12명씩총 48명을대상으로하였다. 대상자정보는 Table 1과같다. 일반아동은부모, 어린이집 / 유치원선생님의보고에의하면 (1) 일반적인발달을하고, (2) 장애가없으며, (3) 수용 표현어휘력검사 (REVT; Kim, Hong, Kim, Jang, & Lee, 2009) 중수용어휘력검사에서 10%ile 이상으로언어발달에문제가없었다. 말소리장애아동은 (1) 사설언어치료실, 복지관등에서언어재활사로부터말소리장애로진단받은아동들로, (2) 아동용발음평가 (APAC; Kim, Pae, & Park, 2007) 에서 10%ile 이하에속하였으며, 3) 음운인식평가나중재를받은이력이없었다. 두집단아동모두부모, 어린이집 / 유치원선생님으로부터청력, 정서, 인지, 사회성에문제가없다고보고된아동이다. 도구음운인식과제는 Oh, Seo, Ko와 Kim (2016) 의단어및음절탈락과제를이용하였다. 과제는총 20문항으로구성되었고연습단계 3 문항을포함하였다. 음운인식과제는 Appendix 1과같다. 검사는연속된 5문항에서실패하면종료하였으며음운인식점수는정반응 한문항의수로계산하였다. 말소리능력을살펴보기위해 APAC을사용하였고아동의모든반응은녹음기를통해녹음하였으며녹음된발화를듣고전사하여채점하였다. 어휘력을살펴보기위해 REVT 중수용어휘력검사를사용하였으며원점수와백분위점수로결과를산출하였다. 절차일반아동과말소리장애아동을대상으로말소리, 어휘, 음운인식과제순으로평가를진행하였으며각아동당평가에소요된시간은총 40분이었다. 일반아동은아동이재원중인유치원내개별적으로검사가가능한공간에서실시하였고말소리장애아동은아동이다니고있는복지관및언어치료실내개별적으로검사가가능한공간에서실시하였다. 총자료수집기간은 1년이소요되었으며모든평가는평가후 1일이지나기전에채점하였다. 말소리장애아동의음운인식지연비율은 Oh 등 (2016) 에서제시한 5, 6세일반아동의음운인식점수를기준으로하였다. 통계분석연령과말소리장애유무에따른음운인식, 어휘능력의차이를살펴보기위해다변량분석을실시하였다. 음운인식과자음정확도및어휘력의상관관계를살펴보기위해서상관분석을실시하였다. Table 1. Participants characteristics Age (yr) PCC TD group (N= 12) (0.4) (1.2) SSD group (N= 12) (11.2) (8.0) Values are presented as mean (SD). TD= typically developing children; SSD= speech sound disorders with unknown origin; PCC= percentage of correct consonants. Table 2. Phonological awareness and vocabulary Age (yr) PA Vocabulary TD group (N= 12) (6.9) (13.6) (5.2) (9.9) SSD group (N= 12) (5.9) (16.4) (6.4) (18.6) Values are presented as mean (SD). TD= typically developing children; SSD= speech sound disorders with unknown origin; PA= phonological awareness PA score TD SSD Vocabulary score TD SSD Age (yr) (A) Age (yr) (B) Figure 1. (A) Phonological awareness (PA) and (B) vocabulary scores according to age and disorders. TD= typically developing children; SSD= speech sound disorders with unknown origin

4 말소리장애아동의음운인식과어휘특성 서은영외 PCC.44*.44* Correlation PA.53* No delay 33.3% Both delay 33.3% Vocabulary.68* Figure 2. Correlation of phonological awareness (PA), vocabulary, and percentage of correct consonants (PCC). *p <.001. PA Only vocabulary delay 16.6% Only PA delay 16.6% 연구결과 Figure 3. Rate of phonological awareness (PA) and vocabulary delay. 연령과말소리장애유무에따른음운인식과어휘능력연령과말소리장애유무에따른음운인식, 어휘력점수의평균과표준편차는 Table 2, Figure 1과같다. 음운인식과어휘능력의차이를살펴보기위해다변량분석을실시한결과연령 (F(3, 44) = 6.4, p<.001) 과말소리장애유무 (F(3, 44) =14.7, p<.001) 에따라통계적으로유의한차이가나타났지만연령과말소리장애요인의상호작용효과는통계적으로유의하지않았다 (F(3, 44) =.6, p>.05). 연령이높을수록음운인식과어휘능력이높았으며말소리장애아동은음운인식과어휘에서어려움을보였다. 음운인식, 자음정확도, 어휘능력간의상관관계음운인식, 자음정확도, 어휘능력간의상관관계를살펴보기위해 Pearson 상관분석을실시한결과는 Figure 2와같다. 음운인식, 자음정확도, 어휘능력간상관관계가통계적으로유의한것으로나타났으며특히음운인식과어휘력간의상관이높은것으로나타났다. 말소리장애아동의음운인식과어휘능력지연비율말소리장애아동중음운인식과어휘에지연을보이지않은아동은 24명중 8명 (33%) 으로나타났다. 말소리장애아동중음운인식만지연을보이는비율은 4명 (16%), 어휘만지연을보이는비율은 4명 (16%), 어휘와음운인식에서함께지연을보이는비율은 8명 (33%) 으로나타났으며결과는 Figure 3과같다. 논의및결론본연구는음운발달문제가있는아동의음운인식과어휘특성 을살펴보기위해말소리장애유무에따른집단간차이및음운인식, 어휘, 자음정확도간의상관관계를분석하고, 말소리장애아동중음운인식과어휘발달지연을보이는아동의비율을살펴보았다. 연구결과에따른논의는다음과같다. 첫째, 말소리장애아동은연령에따라음운인식과어휘능력에서차이를보였다. 일반적으로아동의연령이증가함에따라성숙의효과로인해음운인식, 어휘능력이향상되며 (Hong, Jeon, Pae, & Lee, 2002; Liberman, Shankweiler, Fisher, & Cater, 1974; Kim, & Kim, 2006; Park, & Choi, 2014) 이는일반아동뿐아니라말소리장애아동에게도나타난다 (McKinnon, McLeod, & Reilly, 2007; St. Louis et al., 1992). 본연구에서말소리장애아동 24명중 16명 (66%) 은음운인식과어휘능력에서모두지연을보이거나음운인식혹은어휘능력각각에서어려움을보였다. 말소리장애아동의음운인식능력을살펴본연구들은말소리장애아동이음운인식에지연을보인다는연구 (Anthony et al., 2011; Bird et al., 1995; Foy & Mann, 2012; Gillon, 2002; Min, Lee, Choi, & Choi, 2015; Nathan, Stackhouse, Goulandris, & Snowling, 2004; Snowling et al., 2000; Webster, Plante, & Couvilion, 1997) 와지연을보이지않는다는연구 (Lewis, Freebairn, Taylor, 2000; Snowling et al., 2000) 로상반된결과를제시하고있다. 특히언어장애동반유무에따라말소리장애아동의음운인식수행이다른데언어장애를동반한말소리장애아동은음운인식에지연을보이기도하고 (Catts, 1991; Hesketh, 2004; Lewis, & Freebairn, 1992; Nathan et al., 2004; Snowling et al., 2000) 언어장애동반여부와상관없이말소리장애만으로음운인식에지연을보이기도한다 (Gernand, & Moran, 2007; Rvachew et al., 2003). 말소리장애아동의음운인식능력에대해연구결과마다차이를보이는이유는

5 Eun-Young Seo, et al. Phonological Awareness and Vocabulary of Children with SSD 말소리장애아동의언어장애동반유무, 음운인식을측정하는과제, 측정방법등에기인할수있다. 또한말소리장애아동집단의음운인식점수범위는광범위하게나타났는데 Shriberg, Austin, Lewis, McSweeny 와 Wilson (1997) 은말소리장애와언어장애를동시에보이는아동의수행평균과범위가다양하다는것을언급하면서연구마다서로다른측정도구와기준이상이함을그이유로제시하였다. 말소리장애아동이음운인식에어려움을보이는이유에대해서말소리장애아동은단어를개별적인음소보다전체로인식하기때문에단어에포함된개별음소를조작하는데어려움을보일수있고 (Bird et al., 1995) 단어에대한음운정보에접근하고저장하는데결함을보이기때문으로설명하기도한다 (Sutherland & Gillon, 2005). Lewis 등 (2000) 은말산출문제가음운에의한것이고언어장애를동반하고있는아동의경우숙련된음운인식과읽기를달성하는데에실패할위험이크다고주장하였다. 음운인식이이후문해문제를예측하고예방하는데기여한다는사실에는큰이견이없으며이는말소리장애아동에게도해당된다. 따라서말소리장애아동이음운인식에어려움을보이거나더나아가이후문해기술에어려움을보일위험이있다면지속적인모니터링과차별적인평가및중재가요구된다. 음운인식에지연을보이는말소리장애아동을대상으로말소리산출과음운인식에대한중재를적용했을때더나은문해기술을입증한연구도있다 (Gillon, 2002; Kirk & Gillon, 2007; Kirk, Capri, Moore, & Feusahrens, 2010). 말소리장애아동의음운인식및어휘수행과관련된요인으로말소리의오류패턴, 심각도가고려되어야한다 (Leitao et al., 1997). 본연구에서는이후문해기술과관련되거나예측할수있는요인중음운인식과어휘능력만을살펴보았기때문에말소리장애의지속기간, 말소리오류패턴, 심각도와의관계를연구할필요가있겠다. 둘째, 음운인식, 어휘, 자음정확도간에상관관계가나타났으며특히음운인식과어휘능력간의상관이높은것으로나타났다. 음운인식과자음정확도간의관계는아직명확하지않아음운인식과자음정확도간의관계에대한연구들은상반된결과를제시하고있다. 음운을표현하는능력과음운인식간의긴밀한상관관계가있다는연구도있고 (Bird et al., 1995; Bishop & Adams, 1990; Larrivee & Catts, 1999; McDowell et al., 2007) 음운인식과자음정확도간의상관관계를찾을수없다는연구도있다 (Gillon, 2005; Nathan et al., 2004; Rvachew & Grawburg, 2006; Shin, Park, & Seok, 2006). 본연구에서는음운인식과자음정확도간에중간정도 (.44) 의상관관계가나타났는데음운을표현하는능력이부족한아동은음운인식에서어려움을보일수있다는것을의미한다 (Webster et al., 1997). 그러나많은연구에서음운인식과자음정확도의상관관계가작거나나타나지않았는데 Overby, Trainin, Smit, Bernthal 과 Nelson (2012) 은말소리산출능력이높으면음운인식발달에긍정적인영향을미치는것으로나타났지만연구들간에상이한결과를보여주고있으므로관련된매개변수와의관계를파악하는것이중요하다고하였다. 학령기문해기술에영향을미치는요인중어휘와음운인식간의긴밀한관계는잘알려져있다 (Cooper, Roth, Speece, & Schatschneider, 2002; Metsala, 1999). 어휘집에저장되어있는정보로부터음운규칙을인출한다는것을가정했을때어휘결함이음운산출상의어려움에영향을미칠수있고 (Dodd, 2005) 어휘량이많을수록더다양한말소리와음절구조를산출할수있다 (McCune & Vihman, 2001). 어휘의성장이음운인식능력에영향을미치기때문에 (Walley, 1993) 수용어휘가많은아동은음운인식과제를더잘수행할수있으며 6세의수용언어가 8세의음운인식을가장잘예측해주기도하였다 (Olofsson & Neidersoe, 1999). 음운인식과수용어휘기술간의관련성은말소리장애아동에게도나타났다 (Rvachew & Grawburg, 2006). 본연구에서도음운인식과어휘간에강한상관관계 (.68) 가나타났으며말소리를산출하는능력보다어휘능력이음운인식과관련이있다는것을확인할수있었다 (Nathan et al., 2004). 셋째, 말소리장애아동 24명중 8명 (33%) 이음운인식과어휘에지연을보였으며 4명 (16%) 은음운인식만지연을보이고 4명 (16%) 은어휘에서만지연을보였다. 말소리장애아동의음운인식지연비율을살펴본연구들은 20%-93% 로비교적넒은범위의비율을제시하고있다. Nathan 등 (2004) 은추적조사를통해 4, 5, 6세에말소리장애를보였던 47명의아동이 6세 9개월이되었을때읽기와철자수행에서어려움을보이는비율을살펴보았을때말소리장애만보였던집단의 47%, 말소리장애와언어장애를함께보였던집단의 68% 를제시한바있다. 또한 Broomfield 와 Dodd (2004) 는 320명의말소리장애중음운인식에지연을보이는비율은약 70%, 지연을보이지않는비율을 30% 로제시하였다. 국내의연구에서 Ko와 Kim (2010) 은 20명의말소리장애아동중지연을보이는비율을 40% 로제시하였다. 본연구에서음운인식지연비율은약 50% 로나타났으며연구마다비율의차이를보이는이유는대상아동의수와연령, 음운인식능력을측정하는방법 ( 과제의종류, 과제의수준 ), 음운인식문제를정의하는기준등연구방법에서의차이에기인할수있다. 국내에서말소리장애아동의음운인식특성에대해많은연구가이루어졌지만구체적인비율을제시한연구는제한적이다. 본연구는많은음운인식과제중탈락과제만사용하였고음

6 말소리장애아동의음운인식과어휘특성 서은영외 소차원을배제하였기때문에다른연구들이제시한비율과차이가나타났다고할수있다. 또한음운인식과어휘에문제를보이지않고순수하게말소리장애만을보이는비율이 24명중 8명 (33%) 으로나타났다. 따라서음운인식과어휘문제의동반여부에따라서말소리장애아동은음운인식만지연되는경우, 음운인식과어휘가함께지연되는경우, 음운인식에문제가없는경우등의이질적인하위집단으로나눌수있을것이다. 본연구는말소리장애아동의이후문해기술에영향을미치는요인으로알려진음운인식, 어휘, 자음정확도와의관계를살펴봄으로써말소리장애아동이동반하고있는문제의특성을확인하고자하였으며동반하고있는문제에따른차별적인평가와중재의필요성을제안하였다. 임상현장에서말소리문제로의뢰되는아동들은전형적으로표준화된조음평가를통해문제를보이는음소혹은음운오류패턴에대한중재를받는다. 그러나본연구의결과를토대로말소리장애아동이음운인식및어휘능력에지연을보인다면이후학령기에나타날수있는문해기술의문제를예방하기위해학령전기의음운인식, 초기문해기술에대한직접적인중재와지속적인모니터링이필요함을시사한다. 본연구에서는말소리장애의문해기술과관련된요인중음운인식과어휘능력을살펴보았는데 Lewis 등 (2015) 은말소리장애의지속성, 비언어성지능, 사회경제적지위 (SES) 등도영향을미친다고하였다. 따라서말소리장애아동의이후문해기술과관련된말소리오류패턴, 심각도, 말소리장애의지속성, 비언어성지능, 사회경제적지위등과같은요인과의관계를살펴볼필요가있겠다. REFERENCES Anthony, J. L., Aghara, R. G., Dunkelberger, M. J., Anthony, T. I., Williams, J. M., & Zhang, Z. (2011). What factors place children with speech sound disorders at risk for reading problems? American Journal of Speech-Language Pathology, 20, Bernthal, J. E., Bankson, N. W., & Flipsen, P. (2013). Articulation and phonological disorders: speech sound disorders in children (7th ed.). Boston, MA: Pearson. Bird, J., Bishop, D. V., & Freeman, N. H. (1995). Phonological awareness and literacy development in children with expressive phonological impairments. Journal of Speech, Language, and Hearing Research, 38, Bishop, D. V., & Adams, C. (1990). A prospective study of the relationship between specific language impairment, phonological disorders and reading retardation. Journal of Child Psychology and Psychiatry, 31, Bradley, L., & Bryant, P. E. (1983). Categorizing sounds and learning to read: a causal connection. Nature, 301, Broomfield, J., & Dodd, B. (2004). The nature of referred subtypes of primary speech disability. Child Language Teaching and Therapy, 20, Burgess, S. R., & Lonigan, C. J. (1998). Bidirectional relations of phonological sensitivity and prereading abilities: evidence from a preschool sample. Journal of Experimental Child Psychology, 70, Catts, H. W. (1991). Facilitating phonological awareness: role of speech-language pathologists. Language, Speech, and Hearing Services in Schools, 22, Catts, H. W. (1993). The relationship between speech-language impairments and reading disabilities. Journal of Speech, Language, and Hearing Research, 36, Cooper, D. H., Roth, F. P., Speece, D. L., & Schatschneider, C. (2002). The contribution of oral language skills to the development of phonological awareness. Applied Psycholinguistics, 23, Dodd, B. (2005). Differential diagnosis and treatment of children with speech disorder (2nd ed.). Philadelphia, PA: Whur. Forrest, K., Chin, S. B., Pisoni, D. B., & Barlow, J. N. (1994). Talker normalization in normally articulating and phonologically delayed children: methodological considerations. Research on Spoken Language Processing, 19, Foy, J. G., & Mann, V. (2001). Does strength of phonological representations predict phonological awareness in preschool children? Applied Psycholinguistics, 22, Foy, J. G., & Mann, V. A. (2012). Speech production deficits in early readers: predictors of risk. Reading and Writing, 25, Gernand, K. L., & Moran, M. J. (2007). Phonological awareness abilities of 6-year-old children with mild to moderate phonological impairments. Communication Disorders Quarterly, 28, Gillon, G. T. (2002). Follow up study investigating the benefits of phonological awareness intervention for children with spoken language impairment. International Journal of Language & Communication Disorders, 37, Gillon, G. T. (2005). Facilitating phoneme awareness development in 3-and 4-year-old children with speech impairment. Language, Speech, and Hearing Services in Schools, 36, Hemphill, L., & Tivnan, T. (2008). The importance of early vocabulary for literacy achievement in high-poverty schools. Journal of Education for Students Placed at Risk, 13,

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9 Eun-Young Seo, et al. Phonological Awareness and Vocabulary of Children with SSD Appendix 1. 음운인식선별검사 1. 연습단계 1 아동에게 꽃 그림과 병 그림을보여주고합하여 꽃병 을말하게한다. 2 아동이반응한후검사자는 꽃 그림을가린후, 이번에는꽃병에서 꽃 을빼고말해보세요. 라고지시한다. 3 이절차를 종이컵 ( 종이와컵그림 ), 딸기우유 ( 딸기와우유그림 ) 에서반복한다. 4 아동이실패했을경우, 검사자는적절한반응을알려준다. 2. 검사단계 1) 음운인식검사지시문 자이제선생님이단어를들려줄거에요. 잘듣고선생님이빼라는소리를빼고말해주세요 2) 음운인식검사요령 1 검사자는목표낱말을읽어준뒤, 밑줄친부분을빼고각각의검사항목을말하게한다.( 예 : 야구방망이에서 / 야구 / 를빼고말해보세요 ) 2 검사항목은그림을사용하지않고실패해도피드백을주지않는다. 3 연속해서 5개문항에서실패하면검사를종료한다. 3. 채점요령 1) 검사자는아동의반응을정반응 (+), 오반응 (-) 으로기입한다. 2) 총 20 개의문항중맞게반응한항목의수를세어원점수로계산한다. 3) 조음에오류가있지만각검사항목에맞게정반응하였다면맞는것으로채점한다. 음운인식검사채점지 이름 (ID): ( ), 생년월일 ( 연령 ): ( ), 성별 : 검사일 :, 검사자 : 음운인식검사항목 검사항목 반응 검사항목 반응 검사항목 반응 1 야구방망이 8 비옷 15 휴지통 2 동전지갑 9 창문 16 호랑이 3 손톱깎이 10 놀이터 17 축구공 4 소고기 11 코끼리 18 유리창 5 책가방 12 수요일 19 오토바이 6 신발장 13 풍선 20 안녕하세요 7 물총 14 바지 총점 /

10 말소리장애아동의음운인식과어휘특성 서은영외 국문초록 말소리장애아동의음운인식과어휘특성 서은영 1 고유경 1 오경아 1 김수진 2 1 나사렛대학교일반대학원언어치료학과, 2 나사렛대학교언어치료학과 배경및목적 : 말소리장애아동은동반하고있는문제가다양한이질적인집단이다. 특히말소리장애아동이동반하고있는문제중언어, 어휘, 음운인식의문제는이후문해기술을예측하고문제를예방하는데중요한요인이다. 따라서본연구는말소리장애아동의문해기술과관련된음운인식과어휘특성을살펴보고음운인식, 어휘, 자음정확도간상관관계를살펴보고말소리장애아동이음운인식과어휘에서지연을보이는비율을살펴보고자하였다. 방법 : 일반아동과말소리장애아동각각 24명씩을대상으로말소리, 음운인식, 어휘능력을평가하였다. 결과 : 연령과말소리장애유무에따라음운인식, 어휘능력에유의미한차이가나타났으며, 음운인식이자음정확도보다어휘능력과더큰상관을보였다. 말소리장애아동중음운인식과어휘에서모두지연을보이는비율은 33%, 음운인식만지연을보이는비율은 16%, 어휘만지연을보이는비율은 16%, 순수한말소리장애의비율은 33% 로나타났다. 논의및결론 : 말소리장애아동이동반하고있는문제의특성을확인하고차별적인평가와중재의필요성을제안하였다. 핵심어 : 말소리장애아동, 음운인식, 어휘, 문해기술 참고문헌 고유경, 김수진 (2010). 기능적조음음운장애아동과일반아동의음운인식과읽기능력의비교및상관. 언어청각장애연구. 15, 김민정, 김수진, 하지완, 하승희 (2015). 말소리장애의동반장애유형및말-언어특성에관한설문조사. 언어청각장애연구, 20, 김민정, 배소영, 박창일 (2007). 아동용발음평가 (APAC). 인천 : 휴브알엔씨. 김선정, 김영태 (2006). 음운생략과제를통한 5-6세아동의음운인식발달및음운처리능력과의상관도연구. 언어청각장애연구, 11, 김영태, 홍경훈, 김경희, 장혜성, 이주연 (2009). 수용 표현어휘력검사 (REVT). 서울 : 서울장애인종합복지관. 민종현, 이경재, 최성희, 최철희 (2015). 학령기말소리장애아동과일반아동의음운인식및쓰기능력. 언어치료연구, 24, 박보라, 최예린 (2014). 4-5세일반아동의초기읽기능력과시지각및음운인식능력간관련성. 언어치료연구, 23, 신혜정, 박희정, 석동일 (2006). 한국 4-6세아동의음운인식발달과자음정확도간의상관관계연구. 난청과언어장애, 29, 오경아, 서은영, 고유경, 김수진 (2016). 4, 5, 6세아동을위한음운인식선별검사개발. 한국음성학회가을학술대회발표논문집, 홍성인, 전세일, 배소영, 이익환 (2002). 한국아동의음운인식발달. 언어청각장애연구, 7,